D-dimer: a characteristic of the coagulation state of each patient with chronic atrial fibrillation

Mahé, Isabelle; Drouet, Ludovic; Chassany, Olivier; Mazoyer, E.; Simoneau, Guy G.; Knellwolf, Anne‐Laure; Caulin, C; Bergmann, Jean‐François

doi:10.1016/s0049-3848(02)00184-6

Cited by 36 publications

(23 citation statements)

References 27 publications

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“…In addition, as with other authors, no correlation was found between DD level and the INR, suggesting that both dosages carry different but complementary information [2,3,7].…”

Section: Discussionsupporting

confidence: 75%

“…The small number of thromboembolic events lead us to focus on the analysis of DD and death as endpoints: we showed that high DD levels in patients with AF are independently associated with a poor prognosis, irrespective of the age of patients. This is of great importance since, with increasing age, the incidence of AF and DD levels both increase [7][8][9] as thromboembolic and haemorrhagic risk do, making the choice of the antithrombotic therapy in elderly patients with AF especially difficult.…”

Section: Discussionmentioning

confidence: 99%

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D-dimer can predict survival in patients with chronic atrial fibrillation

Mahé

Drouet²,

Simoneau³

et al. 2004

Blood Coagulation &Amp; Fibrinolysis

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High mean levels of D-dimers (DD), markers of fibrin product and degradation, have been reported in patients with atrial fibrillation. In order to determine the predictive value of DD, 125 consecutive patients (mean age, 78 years) with chronic atrial fibrillation without acute disease were prospectively included. DD were quantified by Liatest at inclusion. Patients were followed for a mean duration of 2 years. DD and age at inclusion were significantly higher in patients who would die (n = 54) than in those who would not (n = 65). After multiple analysis of variance, age was not significantly related to prognosis (P = 0.36); low DD (P = 0.03) and oral anticoagulant therapy (P = 0.0192) were independently related to survival. In conclusion, a single determination of DD can strongly predict survival over the following 2 years. It may contribute to the risk stratification and perhaps to the choice of the antithrombotic therapy in high-risk patients with elevated DD.

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“…In addition, as with other authors, no correlation was found between DD level and the INR, suggesting that both dosages carry different but complementary information [2,3,7].…”

Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

D-dimer can predict survival in patients with chronic atrial fibrillation

Mahé

Drouet²,

Simoneau³

et al. 2004

Blood Coagulation &Amp; Fibrinolysis

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show abstract

“…There is ongoing intravascular fibrin formation in patients with atrial fibrillation (AF), and AF is associated with increased risk of thromboembolic events [1]. Effectiveness of oral anticoagulant therapy in reducing thromboembolic events is well documented [2,3,4]; however, levels of coagulative markers can remain elevated despite initiation of oral anticoagulant therapy in some patients [1,5,6,7]. Notably, D -dimer level increased along with the accumulation of clinical risk factors [8].…”

Section: Introductionmentioning

confidence: 99%

<i>D</i>-Dimer Levels in Combination with Clinical Risk Factors Can Effectively Predict Subsequent Thromboembolic Events in Patients with Atrial Fibrillation during Oral Anticoagulant Therapy

Sadanaga¹,

Kohsaka²,

Ogawa

2010

Cardiology

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Objectives: Atrial fibrillation (AF) is associated with hemostatic abnormality and increased risk of thromboembolic events. The aim of the present study was to evaluate whether elevated D-dimer levels in combination with clinical risk factors can adequately predict subsequent thromboembolic events in patients with AF. Method: This was a post hoc analysis of the single-center, prospective observational study. Consecutive patients with nonvalvular AF (245 patients, 74 ± 9 years) treated with warfarin were included. D-dimer levels were measured in combination with clinical risk factors to assess the relationship of this parameter with subsequent thromboembolic events. Results:D-dimer levels were elevated (≧0.5 µg/ml) in 55 (22%) patients. During an average follow-up time of 756 ± 223 days, 9 (1.8%/year) thromboembolic events occurred. Cox proportional hazard analysis showed that elevated D-dimer levels (hazard ratio, HR, 14.3, p < 0.01) as well as high CHADS₂ score (≧3; HR 9.43, p < 0.01) was associated with thromboembolic events. C-statistic improved to 0.848 from 0.781 when D-dimer level was added to the predictor model based on CHADS₂ score. Elevated D-dimer levels also predicted thromboembolic events in the subgroup of patients with high CHADS₂ score (n = 76, HR 12.1, p = 0.021). Conclusion: CHADS₂ scores and D-dimer level can be a useful marker of subsequent thromboembolic events in patients with AF during oral anticoagulant therapy and combination of these can effectively predict thromboembolic events.

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“…The correlation between anticoagulation control quality and D-dimer levels is still controversial. Some previous studies 20, 21 found no significant correlation between INR levels and Ddimer levels in patients with AF. However, anticoagulation control quality might not have been evaluated appropriately in those studies; 20,21 a single determination of INR was used in the analysis.…”

Section: Major Findingsmentioning

confidence: 72%